Genital Herpes

Genital herpes is a highly contagious infection that is caused by a virus. Genital herpes causes fluid-filled blisters or sores on the skin of the genitals (areas on or around the vagina or penis). The infection can also cause blisters on the anal opening, on the buttocks or thighs, inside the vagina on the cervix, or in the urinary tract of women and men.

The infection is caused by the herpes simplex virus (HSV). There are two different types of HSV:

Herpes simplex type 1 virus (HSV-1)

Herpes simplex type 2 virus (HSV-2)

HSV-2 is usually the cause of genital herpes. But, it can also be caused by HSV-1. HSV-1 is the virus that is associated with oral herpes ( cold sores on the mouth).

HSV is a very common sexually transmitted infection. It is transmitted from skin-to-skin contact, especially in places that are warm and moist. The virus enters your body through a cut or opening in the skin or through mucous membranes—the moist inner lining of the urinary tract (in the vaginal area) or the digestive system that includes the mouth, esophagus, stomach, intestines, and anus. Then the virus stays in the nerve cells of your body. The virus is still there, even if you do not have any symptoms of genital herpes. Genital herpes is a chronic, life-long infection with symptoms that will come and go throughout your life. But, the frequency or severity of the condition may decrease over time.

Your doctor will ask about your symptoms and medical history. A physical exam will be done.

It is important for you to be open and honest with your doctor about your symptoms and your sexual history. Your doctor needs this information so that he can properly diagnose you and provide you with the proper treatment. Your doctor will not judge you or your behavior.

Sometimes genital herpes is easy to diagnose because the blisters or open sores are easily visible. However, just examining the sores or the rash is not enough. Also, you can have genital herpes even if the sores are not visible.

There are a number of lab tests available to diagnose genital herpes.

Viral Culture

If your infection is visible, your doctor will rub a swab over an open sore or blister to collect some cells. The cells are then tested to see if the virus is present in those cells. It is recommended that this culture test be taken soon after symptoms appear.

This type of test is not always reliable, though. If the sore is healing or if you have recurrent outbreaks, the test may give a "false-negative." This means that the test reports that you do not have herpes, when you really do have the virus.

Polymerase Chain Reaction (PCR)

PCR is a molecular diagnostic test. It can identify the virus if it has been damaged by the body’s immune system and may not grow in a standard culture. Like the viral culture, you could get a false-negative with this test, as well. But, the PCR test is much more accurate.

Blood Tests

Your doctor may choose to do a blood test. These blood tests are also called antibody tests because they measure herpes simplex virus (HSV) antibodies—the disease-fighting substances in the blood. If the blood tests show HSV antibodies, you are most likely infected with the virus.

Tests can distinguish between herpes simplex type 1 virus (HSV-1) and herpes simplex type 2 virus (HSV-2). This is done by assessing glycoproteins (a type of protein) that are specific to the two kinds of viruses. It is important that your doctor finds out if you have HSV-1 or HSV-2 because your treatment and counseling may be different depending on which virus you have.

Change Your Sexual Practices

Abstain or refrain from sex.—This is the most certain way to avoid contracting genital herpes .

Have a long-term mutually monogamous (only one exclusive sexual partner) with someone who does not have genital herpes.

Always use a latex condom when you do have sex.— It is important to know that the virus can be found on the skin in areas that are not covered by a condom. So, even with protection, there is still a chance that you can contract the virus from others.

Herpes simplex type 1 virus (HSV-1) causes cold sores (blisters around the mouth), which can also spread to the genital area. If you or your partner has a cold sore, avoid kissing or engaging in oral sex.

If your partner has genital herpes, take special precautions . Learn as much as you can about the virus and ways to prevent being infected. Always use a latex condom when having sex. Avoid having sex if your partner has an outbreak. Keep in mind, though, that your partner can spread the virus even when he or she is not having an outbreak.

If you are pregnant, take special precautions to avoid getting genital herpes. Avoid having sex with a partner who has genital herpes. Also avoid having oral sex with a partner who has cold sores.

If you do have unprotected sex with someone who may have genital herpes, talk to your doctor. Tests can be done to find out if you have the virus.

Description of services provided:AHF is dedicated to providing information and clinical education about genital herpes and related diseases. The website offers information for doctors to give to their patients about relevant diseases, features a list of upcoming events relevant to herpes, and provides patients and physicians with links to other websites and organizations that can provide additional information about herpes.

Description of services provided:ASHA’s website offers a list of frequently asked questions about herpes, provides access to chat rooms for group support, provides lists of relevant events, and offers “News You Can Use” about sexually transmitted diseases. The National Herpes Resource Center is a service of ASHA. The Center provides information, makes referrals, serves as an advocate for national policies, sponsors medical research on herpes, and runs herpes awareness campaigns. The organization also runs a hotline to answer questions specific to herpes diagnosis and treatment, as well as communication between partners and with healthcare providers.

Description of services provided:The CDC is part of the government’s Department of Health and Human Services (HHS). The CDC conducts research, promotes health and prevention of disease—with special emphasis on prevention of early risk factors and support of healthy behaviors. The website provides an A-Z index of medical conditions, with links to additional information. In addition, the CDC runs a National Sexually Transmitted Disease hotline.

Description of services provided: IHMF’s goal is to improve the awareness and understanding of herpes viruses. It also promotes counseling for and management of people with these infections. The website offers information for patients and physicians about herpes viruses, including providing guidelines developed for the management of herpes, access to Herpes —the journal of IHMF, information about treatments, and resources for physicians. The US affiliate is the American Herpes Foundation.

Description of services provided: NIAID supports research for allergic and infectious diseases, including genital herpes. The Division of Microbiology & Infectious Diseases offers an informative fact sheet about genital herpes. On the website, you can get news and event information, and updates on research programs.

Last reviewed December 2011 by Rosalyn Carson-DeWitt, MD

Last updated Updated: 12/30/2011

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

It is possible to develop genital herpes with or without the risk factors listed below. However, the more risk factors you have, the greater your likelihood of becoming infected with genital herpes. If you have a number of risk factors, ask your doctor what you can do to reduce your risk.

The virus can spread from direct person-to-person contact. Any sexual or non-sexual contact involving the mouth, genitals, or anus can increase the risk of the virus being transmitted.

Behaviors/Lifestyle

Having unprotected sex (vaginal, anal, or oral sex)—For example, if your partner has a cold sore and performs oral sex, you can get genital herpes.

Becoming sexually active at a young age

Having been sexually active for many years

Having multiple sexual partners

Having a partner who is infected with genital herpes

Engaging in male homosexual activity

Gender

Women are more likely to be infected with genital herpes.

Socioeconomic Factors

Being a young adult

Many new infections occur in adolescents and young adults.

In young adults, herpes simplex type 1 virus, which causes cold sores, is becoming a more common cause of genital herpes.

Health Factors

Having a mother with genital herpes increases a newborn's risk of getting the virus

Screening Guidelines

Screening for genital herpes is not recommended for everyone. But, if you are being tested or treated for other sexually transmitted disease , your doctor may screen you for genital herpes. Having multiple sex partners puts you at an increased risk of being infected with the virus.

If you are pregnant, your doctor will ask you if you have genital herpes and examine you for any sores in your genital area. A test may also be done to find out if you do have the virus. This is especially important at the time of labor to avoid spreading the virus to your baby.

If you have genital herpes you may not know it. Most people are not aware that they have genital herpes because they may not have experienced any symptoms. They may also not recognize the symptoms. When you first become infected, symptoms begin to appear within 2-10 days.

Early symptoms that can last 2-3 weeks include:

Itching, burning, and/or pain in the genital or anal area

Discharge from the vagina

Flu-like symptoms, such as fever and swollen glands

Pressure in the abdomen (the area below the stomach)

As the infection progresses, symptoms of an outbreak include:

Sores that start to form on the part of the body where the virus was contracted

Sores that begin as small red bumps, develop into blisters, and then become painful open sores

Sores or blisters that appear and occur in clusters or small groupings

After a few days, the sores form a scab-like outer layer and then fall off.

The virus will reoccur and become active and inactive (symptoms will come and go) over time. The frequency of these reoccurrences vary from person to person. You may experience symptoms a number of times throughout the year or you may only experience an outbreak once or twice in your lifetime. Doctors and researchers do not yet know why these reoccurrences happen.

Each Case Is Unique

The average number of outbreaks people have each year is about four or five. The first year of the virus is usually the worst. The first outbreak is usually the most severe and painful, with the second outbreak often happening only a few weeks later. Also, you may tend to experience more outbreaks the first year. The good news is that, as time goes on, the frequency of outbreaks lessens and they become much less severe. Reoccurrences tend to become milder and do not last as long. Sometimes, you may even be able to feel when an outbreak is about to occur.

Keep in mind, some people have genital herpes but do not have symptoms. You can still spread genital herpes even if you have no symptoms. It is a virus that stays in your system.

Many people fail to recognize the symptoms of genital herpes. Women often confuse the discomfort with their menstrual period or a yeast infection . Men often confuse the symptoms with jock itch or friction burn.

If you have any symptoms of genital herpes, see your doctor right away.

In addition to your physical health, Genital herpes can affect your mental health, as well. Concern about outbreaks or of spreading the disease to your partner or your baby may cause you to feel scared, anxiety , stressed, and even depression . Also, depending on how you contracted the disease, you may feel betrayed, angry, and alone.

Speak with your doctor if you begin to experience these feelings, especially if they interfere with how you are living or enjoying your life. In addition to your primary care doctor, you may need counseling. Support from a mental health professional can help you deal with your emotions so that you can move on and live your life to the fullest. Visit the American Social Health Association’s website to find local, free, and confidential support groups for people concerned about herpes.

Although there is no cure for genital herpes, it can be managed so that it is less severe and so that outbreaks do not last as long. If you have genital herpes, you can learn to manage the condition and live your life.

General Tips for Gathering Information

Here are some tips that will make it easier for you to talk to your doctor:

Bring someone else with you. It helps to have another person hear what is said and think of questions to ask.

Write out your questions ahead of time, so you don’t forget them.

Write down the answers you get, and make sure you understand what you are hearing. Ask for clarification if necessary.

Do not be afraid to ask your questions or ask where you can find more information about what you are discussing. You have a right to know.

Is there any progress in research to find a cure or to prevent genital herpes entirely?

How can I stay aware of the news about what is happening in genital herpes research?

Where can I find a support group about genital herpes?

Do you recommend any additional counseling?

About Lifestyle Changes

Is there anything else I can do to minimize any discomfort I may experience?

How do I tell my partner that I have genital herpes?

Do I have to tell my family about genital herpes?

How can I protect my partner?

Should my partner come in for a test and treatment?

Can I still have sex?

How will having genital herpes affect my relationship with my partner?

Are there any dietary changes I should make?

Will exercise affect genital herpes?

About Your Outlook

How often will I have an outbreak?

How can I become pregnant if I have genital herpes? How can I get my partner pregnant if I have genital herpes?

Can I take medicine if I am pregnant? How can I protect my baby?

Where can I get more information about genital herpes?

Genital herpes is a lifelong condition. There are, however, medicines that you can take to treat the symptoms and prevent future outbreaks. Managing genital herpes includes changing your lifestyle habits, as well.

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY.
Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.